Health care professionals dealing with hemophilia: Insights from the international qualitative study of the HERO initiative

Background: Assessing the viewpoints of health care professionals concerning their work with chronic patients is a relatively new research topic, widely overlooked in the literature. However, understanding their subjective work experience is highly relevant for identifying problems and perceived resources, enhancing health service organisation, improving relationships or communication with patients, and maintaining well-being. Purpose and method: Qualitative data from the \u201cHaemophilia Experience, Results and Opportunities\u201d Initiative \u2013 a research program aimed at investigating the psychosocial aspects of hemophilia \u2013 were used to evaluate the experiences of 62 professionals from seven countries around the world. Semi-structured interviews were submitted to thematic analysis of elementary contexts with the aid of T-Lab software. Results: Five dominant themes emerged, identifying the main challenges that professionals have to deal with in their everyday work practice: caring for impaired adult patients; handling policies and stakeholders; providing counselling on diagnosis and reproductive choices; considering the role of family dynamics; coping with adolescent patients. Conclusion: The outcomes of the study provide an opportunity to develop the area of the non-technical skills in the core curriculum of those who work with chronic illnesses by focusing on cross-professional competences and by improving a comprehensive care model for hemophilia patients

Probabilistic Amplitude Shaping for Continuous-Variable Quantum Key Distribution with Discrete Modulation over a Wiretap Channel

To achieve the maximum information transfer and face a possible eavesdropper, the samples transmitted in continuous-variable quantum key distribution (CV-QKD) protocols are to be drawn from a continuous Gaussian distribution. As a matter of fact, in practical implementations the transmitter has a finite (power) dynamics and the Gaussian sampling can be only approximated. This requires the quantum protocols to operate at small powers. In this paper, we show that a suitable probabilistic amplitude shaping of a finite set of symbols allows to approximate at will the optimal channel capacity also for increasing average powers. We investigate the feasibility of this approach in the framework of CV-QKD, propose a protocol employing discrete quadrature amplitude modulation assisted with probabilistic amplitude shaping, and we perform the key generation rate analysis assuming a wiretap channel and lossless homodyne detection

Local community perceptions on sea turtle egg consumption in Redang Island, Malaysia

info:eu-repo/semantics/publishe

a compact silicon coherent receiver without waveguide crossing

A monolithically integrated silicon coherent receiver based on a novel scheme with a crossing-free 90 $^{\circ}$ hybrid optical coupler and two balanced germanium photodetectors is reported. The integrated receiver is compact (footprint is $0.8\times 1.0\ \hbox{mm}^{2}$ ), and it is demonstrated by working with single-polarization 56-Gb/s quadrature phase-shift keying (QPSK) and 80-Gb/s 16-quadrature amplitude modulation (16-QAM) signals. In particular, QPSK transmission that is back-to-back at 28 Gbaud shows a bit-error rate (BER) below $10^{-4}$ for an optical signal-to-noise ratio (OSNR) lower than 17 dB, whereas 16-QAM at 20 Gbaud shows a BER not better than $3^{\ast}10^{-2}$ because of the nonideal behavior of the device. Reasons for the performance limitations are discussed

WISP-2 expression induced by Teriparatide treatment affects in vitro osteoblast differentiation and improves in vivo osteogenesis

The Osteocyte, recognized as a major orchestrator of osteoblast and osteoclast activity, is the most important key player during bone remodeling processes. Imbalances occurring during bone remodeling, caused by hormone perturbations or by mechanical loading alterations, can induce bone pathologies such as osteoporosis. Recently, the active fraction of parathormone, PTH (1-34) or Teriparatide (TPTD), was chosen as election treatment for osteoporosis. The effect of such therapy is dependent on the temporal manner of administration. The molecular reasons why the type of administration regimen is so critical for the fate of bone remodeling are numerous and not yet well known. Our study attempts to analyze diverse signaling pathways directly activated in osteocytes upon TPTD treatment. By means of gene array analysis, we found many molecules upregulated or downregulated in osteocytes. Later, we paid attention to Wisp-2, a protein involved in the Wnt pathway, that is secreted by MLO-Y4 cells and increases upon TPTD treatment and that is able to positively influence the early phases of osteogenic differentiation. We also confirmed the pro osteogenic property of Wisp-2 during mesenchymal stem cell differentiation into the preliminary osteoblast phenotype. The same results were confirmed with an in vivo approach confirming a remarkable Wisp-2 expression in metaphyseal trabecular bone. These results highlighted the anabolic roles unrolled by osteocytes in controlling the action of neighboring cells, suggesting that the perturbation of certain signaling cascades, such as the Wnt pathway, is crucial for the positive regulation of bone formation

Sphingosine-1 phosphate induces cAMP/PKA-independent phosphorylation of the cAMP response element-binding protein (CREB) in granulosa cells

Background and aims: Sphingosine-1 phosphate (S1P) is a lysosphingolipid present in the ovarian follicular fluid. The role of the lysosphingolipid in gonads of the female is widely unclear. At nanomolar concentrations, S1P binds and activates five specific G protein-coupled receptors (GPCRs), known as S1P1-5, modulating different signaling pathways. S1P1 and S1P3 are highly expressed in human primary granulosa lutein cells (hGLC), as well as in the immortalized human primary granulosa cell line hGL5. In this study, we evaluated the signaling cascade activated by S1P and its synthetic analogues in hGLC and hGL5 cells, exploring the biological relevance of S1PR-stimulation in this context. METHODS AND RESULTS. hGLC and hGL5 cells were treated with a fixed dose (0.1 \u3bcM) of S1P, or by S1P1- and S1P3-specific agonists SEW2871 and CYM5541. In granulosa cells, S1P and, at a lesser extent, SEW2871 and CYM5541, potently induced CREB phosphorylation. No cAMP production was detected and pCREB activation occurred even in the presence of the PKA inhibitor H-89. Moreover, S1P-dependent CREB phosphorylation was dampened by the mitogen-activate protein kinase (MEK) inhibitor U0126 and by the L-type Ca2+ channel blocker verapamil. The complete inhibition of CREB phosphorylation occurred by blocking either S1P2 or S1P3 with the specific receptor antagonists JTE-013 and TY52156, or under PLC/PI3K depletion. S1P-dependent CREB phosphorylation induced FOXO1 and the EGF-like epiregulin-encoding gene (EREG), confirming the exclusive role of gonadotropins and interleukins in this process, but did not affect steroidogenesis. However, S1P or agonists did not modulate granulosa cell viability and proliferation in our conditions. Conclusions: This study demonstrates for the first time that S1P may induce a cAMP-independent activation of pCREB in granulosa cells, although this is not sufficient to induce intracellular steroidogenic signals and progesterone synthesis. S1P-induced FOXO1 and EREG gene expression suggests that the activation of S1P\u2013S1PR axis may cooperate with gonadotropins in modulating follicle development

Reconciling nature, people and policy in the mangrove social-ecological system through the adaptive cycle heuristic

© 2021 The Authors. While mangroves are increasingly described as social-ecological systems (SESs), performing SES research is so much more than merely documenting local resource utilisation patterns in case studies. The aim of this paper is to review and show how ecological, human and institutional resilience could be understood and fostered in an era of uncertainty, through the adaptive cycle (AC) heuristic. Uncertainties come in many forms and shapes: climate change, social and economic dynamics, natural disasters, political and institutional disruption and ever-increasing public demands for participation. Social-ecological studies form windows of experimentation that can provide insights beyond their case-specific context. In order to synthesise and structure the cumulative knowledge base arising from existing and future studies, the need for a suitable overarching framework arose. Here, the AC heuristic represents the connectedness between variables of the mangrove SES versus the mangrove's accumulated capital (natural, built, human and social). We posit that the AC heuristic can be used to interpret spatial and temporal changes (ecological, social, economic, political) in mangrove SESs and we exemplify it by using the 2004 Indian Ocean tsunami as well as a century-long silviculture case. The AC, combined with the SES scheme, allows integration of the spato-temporal dynamics and the multi-dimensional character of mangrove SESs. We also reviewed the ecosystem functions, services and disservices of mangrove SESs, linking each of them to SES capital and variable (fast or slow) attributes, which in turn are closely linked to the different axes and phases of the AC. We call upon mangrove scientists from the natural, applied, social and human sciences to join forces in fitting diversified empirical data from multiple case studies around the world to the AC heuristic. The aim is to reflect on and understand such complex dynamic systems with stakeholders having various (mutual) relationships at risk of breaking down, and to prepare for interactive adaptive planning for mangrove forests.Belgian Science Policy Office ‘EVAMAB – Economic valuation of ecosystem services in Man & Biosphere Reserves' - BELSPO (BL/58/UN32); Erasmus Mundus Masters Course in Tropical Biodiversity and Ecosystems (TROPIMUNDO); VLIR-UOS-funded GREENDYKE Project (ZEIN2008PR347); BELSPO-funded MAMAFOREST-Project (SR/00/323); ZMT Academy travel grant; Singapore National Parks Board (NParks); TUYF Charitable Trust; HKU Seed Fund for Research; International Coral Reef Initiative (ICRI); UNEP/GEF Blue Forest Project; Pew Charitable Trust; Department of Science and Technology, India INSPIRE Faculty scheme (IFA18-LSPA111)

Malar J

Background While sub-microscopic malarial infections are frequent and potentially deleterious during pregnancy, routine molecular detection is still not feasible. This study aimed to assess the performance of a Histidine Rich Protein 2 (HRP2)-based ultrasensitive rapid diagnostic test (uRDT, Alere Malaria Ag Pf) for the detection of infections of low parasite density in pregnant women. Methods This was a retrospective study based on samples collected in Benin from 2014 to 2017. A total of 942 whole blood samples collected in 327 women in the 1st and 3rd trimesters and at delivery were tested by uRDT, conventional RDT (cRDT, SD BIOLINE Malaria Ag Pf), microscopy, quantitative polymerase chain-reaction (qPCR) and Luminex-based suspension array technology targeting P. falciparum HRP2. The performance of each RDT was evaluated using qPCR as reference standard. The association between infections detected by uRDT, but not by cRDT, with poor maternal and birth outcomes was assessed using multivariate regression models. Results The overall positivity rate detected by cRDT, uRDT, and qPCR was 11.6% (109/942), 16.2% (153/942) and 18.3% (172/942), respectively. Out of 172 qPCR-positive samples, 68 were uRDT-negative. uRDT had a significantly better sensitivity (60.5% [52.7–67.8]) than cRDT (44.2% [36.6–51.9]) and a marginally decreased specificity (93.6% [91.7–95.3] versus 95.7% [94.0–97.0]). The gain in sensitivity was particularly high (33%) and statistically significant in the 1st trimester. Only 28 (41%) out of the 68 samples which were qPCR-positive, but uRDT-negative had detectable but very low levels of HRP2 (191 ng/mL). Infections that were detected by uRDT but not by cRDT were associated with a 3.4-times (95%CI 1.29–9.19) increased risk of anaemia during pregnancy. Conclusions This study demonstrates the higher performance of uRDT, as compared to cRDTs, to detect low parasite density P. falciparum infections during pregnancy, particularly in the 1st trimester. uRDT allowed the detection of infections associated with maternal anaemia